Terapevt Arkh
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Comparative Study
[A method for the early detection and treatment of patients with iron deficiency states].
In order to optimize the identification of persons with iron deficiency during mass prophylactic screenings, a diagnostic algorithm using a unified questionnaire was proposed and introduced into medical practice. During 1985-1987, a total of 3655 women aged 18 to 54 years belonging to different occupational groups filled in questionnaires at an industrial enterprise of Novosibirsk. The women were distributed into several groups: group I was made up of normal persons, group II of persons at risk, group III of persons with latent iron deficiency, group IV of persons with iron deficiency anemia, and group V of patients with continuously relapsing iron deficiency anemia refractory to therapy. Taking into account the groups indicated, the diagnostic and the treatment and prophylactic measures have been elaborated.
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The paper is concerned with four Marathon athletes who developed grave impairments in hemodynamics and microcirculatory disorders in the organs (collapse, acute renal failure, cerebral abnormalities) and signs of the grave acute syndrome of disseminated intravascular coagulation with thrombohemorrhage and bleeding after competitions carried out under unfavourable conditions (a temperature of 30 degrees C and high air humidity). Three patients died. ⋯ The clinical and laboratory examination of the other 19 Marathon athletes showed that after competitions 6 persons had subclinical hemostatic disorders characteristic of the syndrome of disseminated intravascular coagulation. It is recommended that control and correction of hemostatic disorders should be strictly exercised in athletes experiencing hard and prolonged physical exercise.
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Iron deficiency in the body of women engaged in intellectual activities, is accompanied by efficiency reduction, more noticeable fatigue in the course of a working day and week, deterioration of body functions. The correction of iron deficiency with iron preparations results in a raised volume of work, improvement of its quality, improvement of the state of health, activity and mood. The results of a corrective test (the state of health, activity, mood) can serve a criterion of correction efficacy.
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A study of the indices of iron metabolism in 29 patients with hereditary hemorrhagic telangiectasia revealed a decrease in the level of serum iron, an increase in serum latent and total iron-binding capacity values. The level of blood transferrin studied by radial immunodiffusion was elevated. The level of ferritin in the absolute majority of patients was decreased. The obtained results were indicative of the development of true iron deficiency in the body.